Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $42.24 / $78.01 / $143.16	Facility	26	$42.24	$78.01	$143.16
Aetna Facility/Professional Professional Modifier Low / Median / High Price $230.77 / $345.37 / $873.57	Professional		$230.77	$345.37	$873.57
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.24 / $65.88 / $257.83	Professional	26	$42.24	$65.88	$257.83
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $188.53 / $260.22 / $573.21	Professional	TC	$188.53	$260.22	$573.21
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $83.67 / $83.67 / $83.67	Professional	26	$83.67	$83.67	$83.67
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $276.30 / $354.69 / $777.12	Professional		$276.30	$354.69	$777.12
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $52.87 / $67.04 / $138.27	Professional	26	$52.87	$67.04	$138.27
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $223.41 / $283.27 / $617.61	Professional	TC	$223.41	$283.27	$617.61
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $93.31 / $386.71 / $480.02	Professional		$93.31	$386.71	$480.02
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $73.06 / $73.06 / $73.06	Facility	26	$73.06	$73.06	$73.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $266.26 / $454.59 / $1,065.59	Professional		$266.26	$454.59	$1,065.59
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.84 / $84.82 / $192.32	Professional	26	$44.84	$84.82	$192.32
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $197.83 / $374.00 / $1,136.59	Professional	TC	$197.83	$374.00	$1,136.59
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $271.72 / $360.14 / $623.72	Professional		$271.72	$360.14	$623.72
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $55.90 / $78.18 / $132.02	Professional	26	$55.90	$78.18	$132.02
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $223.50 / $313.20 / $519.52	Professional	TC	$223.50	$313.20	$519.52
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $140.52 / $289.14 / $494.82	Professional		$140.52	$289.14	$494.82
Excellus BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $35.89 / $64.77 / $111.86	Professional	26	$35.89	$64.77	$111.86
Excellus BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $84.31 / $235.11 / $392.47	Professional	TC	$84.31	$235.11	$392.47
Fidelis Facility/Professional Professional Modifier 26 Low / Median / High Price $74.15 / $74.15 / $74.15	Professional	26	$74.15	$74.15	$74.15
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $135.04 / $135.04 / $135.04	Professional	26	$135.04	$135.04	$135.04
MVP Health Care Facility/Professional Facility Modifier 26 Low / Median / High Price $73.06 / $73.06 / $73.06	Facility	26	$73.06	$73.06	$73.06
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $278.29 / $468.23 / $1,065.59	Professional		$278.29	$468.23	$1,065.59
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $48.55 / $86.41 / $192.32	Professional	26	$48.55	$86.41	$192.32
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $217.71 / $364.74 / $1,136.59	Professional	TC	$217.71	$364.74	$1,136.59
United Facility/Professional Professional Modifier Low / Median / High Price $296.81 / $401.49 / $827.06	Professional		$296.81	$401.49	$827.06
United Facility/Professional Professional Modifier 26 Low / Median / High Price $56.94 / $76.76 / $197.96	Professional	26	$56.94	$76.76	$197.96
United Facility/Professional Professional Modifier TC Low / Median / High Price $237.52 / $325.72 / $685.06	Professional	TC	$237.52	$325.72	$685.06
Univera Facility/Professional Facility Modifier 26 Low / Median / High Price $68.47 / $68.47 / $167.53	Facility	26	$68.47	$68.47	$167.53
Univera Facility/Professional Professional Modifier Low / Median / High Price $230.97 / $417.03 / $788.06	Professional		$230.97	$417.03	$788.06
Univera Facility/Professional Professional Modifier 26 Low / Median / High Price $35.89 / $86.25 / $167.53	Professional	26	$35.89	$86.25	$167.53
Univera Facility/Professional Professional Modifier TC Low / Median / High Price $195.08 / $330.77 / $625.07	Professional	TC	$195.08	$330.77	$625.07